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Orthognathic Surgery: Restoring Function, Health, and Facial Harmony

Orthognathic or jaw surgery is a specialised procedure that corrects disordered jaw and facial structures. Oral and maxillofacial surgeons perform it to improve chewing, speaking, breathing, and overall facial balance. Maxillofacial surgeons recommend it for individuals with severe overbites, underbites, crossbites, open bites, or facial asymmetry that orthodontics alone cannot correct. Orthognathic surgery is a corrective jaw surgery that involves procedures designed to restore balance between the upper and lower jaws. Maxillofacial surgeons commonly perform to correct malocclusion, where the teeth do not align properly, to address airway obstruction associated with obstructive sleep apnea, or to enhance facial symmetry and aesthetics. 

Orthognathic Surgery

In many cases, patients undergoing orthodontic treatment with braces may require jaw repositioning to achieve proper bite alignment when orthodontics alone is insufficient. This treatment is typically coordinated through a collaborative approach between an orthodontist and an oral and maxillofacial surgeon to ensure optimal functional and aesthetic outcomes. Orthognathic surgery is a life-changing procedure that improves functionality and transforms facial harmony and confidence.

Why is Orthognathic Surgery Done?

Orthognathic surgery corrects bite issues but fixes misaligned jaws that affect chewing and speaking.

Improves Facial Aesthetics – Enhances symmetry and profile, often leading to a more balanced appearance.

Relieves TMJ Disorders – Can reduce pain and discomfort in the jaw joint.

It Helps with Sleep Apnea and opens airways for better breathing.

It enhances Oral Health and prevents excessive wear on teeth due to misalignment.

Types of Orthognathic Surgery

Maxillary Osteotomy (Upper Jaw Surgery) – Used to fix overbites, open bites, or crossbites.

Mandibular Osteotomy (Lower Jaw Surgery) – Corrects underbites or asymmetrical jaw positioning.

Genioplasty (Chin Surgery) – Modifies the chin position for functional or cosmetic reasons.

The Procedure & Recovery

Pre-Surgery: Patients often wear braces before surgery to prepare the teeth for alignment.

Surgery: Performed under general anaesthesia, the surgeon carefully repositions the jawbones and secures them with plates and screws.

Recovery: Initial healing takes a few weeks, but full recovery may take several months. A soft food diet and physical therapy may be necessary.

Orthognathic surgery offers numerous functional, health, and aesthetic benefits. It corrects jaw misalignment and improves oral and facial harmony. 

Here are the key advantages:

1. Functional Benefits

• Improved Bite Alignment – Corrects malocclusion (overbite, underbite, crossbite, open bite), making it easier to chew and speak.
• Enhanced Speech Clarity – Helps resolve speech difficulties caused by jaw misalignment.
• Better Chewing Efficiency – Reduces strain on teeth and jaw muscles, improving digestion.

2. Health Benefits

• Relief from TMJ Disorders – Reduces jaw pain, headaches, and discomfort associated with temporomandibular joint (TMJ) issues.
• It improves breathing and Sleep quality, opens the airway, treats obstructive sleep apnea (OSA), and reduces snoring.
• Better Oral Health – Properly aligned jaws reduce excessive wear on teeth and decrease the risk of gum disease and cavities.

3. Aesthetic & Psychological Benefits

• Enhanced Facial Symmetry – Improves facial proportions, creating a more balanced and harmonious appearance.
• Boosted Self-Confidence – A more natural-looking jawline and smile can enhance self-esteem and social confidence.

4. Long-Term Benefits

• Prevention of Future Dental Problems – Reduces the risk of tooth loss and jaw deterioration over time.
• Permanent Solution – Unlike temporary treatments, orthognathic surgery provides lasting jaw and bite correction.

With functional and cosmetic concerns, orthognathic surgery can significantly enhance a person’s quality of life, comfort, and overall well-being.

What are the most common orthognathic procedures performed?

Orthognathic surgery includes many procedures to correct jaw misalignment, improve function, and enhance facial balance. The most commonly performed orthognathic procedures are:

1. Maxillary Osteotomy (Upper Jaw Surgery)

• Purpose: Corrects upper jaw (maxilla) misalignment, such as an overbite, open bite, or crossbite.
• Procedure: The surgeon cuts and repositions the maxilla, securing it with plates and screws.
  • Common Uses: Treating a receded or protruding upper jaw
  • Fixing an open bite (where teeth don’t touch when the mouth is closed)
  • Enhancing facial symmetry

2. Mandibular Osteotomy (Lower Jaw Surgery)

• Purpose: Corrects underbite or an overly small/recessed lower jaw.
• Procedure: The lower jaw (mandible) is cut, repositioned, and stabilized with plates and screws.
  • Common Uses: Moving the lower jaw forward or backward
  • Improving bite alignment and chewing function
  • Enhancing facial aesthetics

3. Genioplasty (Chin Surgery)

• Purpose: It Modifies the chin position for both functional and aesthetic improvement.
• Procedure: The chin bone is repositioned and secured to correct receding or protruding chins.
• Common Uses: Enhancing facial balance
• Treating chin asymmetry or a weak chin
• Often combined with other jaw surgeries for optimal results

Genioplasty

4. Segmental Osteotomy (Localized Jaw Correction)

• Purpose: Adjusts specific regions of the jaw rather than repositioning the entire jaw.
• The procedure corrects tiny portions of the upper or lower jaw that are surgically separated and repositioned.
  • Common Uses: Correcting localized dental misalignment
  • Resolving severe crowding of teeth

5. Bimaxillary Osteotomy (Double Jaw Surgery)

• Purpose: Simultaneously corrects both upper and lower jaw alignment issues.
• Procedure: Surgeons reposition the maxilla and mandible to improve function and aesthetics.
  • Common Uses: Severe jaw misalignment affecting both jaws
  • Treating obstructive sleep apnea by increasing airway space
  • Enhancing overall facial proportion

Dental surgeons customise each procedure based on the patient’s needs and perform it with orthodontic treatment to ensure optimal results.

What should families expect after orthognathic surgery?

Families should prepare for a structured recovery process after orthognathic surgery, which includes healing time, dietary adjustments, and follow-up care. Here’s what to expect:

1. Immediate Post-Surgery Period (First Week)

• Swelling and Bruising: The face will be swollen, especially around the jaw and cheeks. Ice packs and prescribed medications help manage this.
• Pain Management: Doctors provide pain relievers to minimize discomfort.
• Restricted Jaw Movement: The surgeon may wire or band the jaw shut to aid healing, which makes speaking and eating difficult.
• Hospital Stay: Most patients stay 1–2 nights in the hospital for monitoring.

2. Diet Adjustments

• Liquid Diet (First Few Weeks): Patients must consume broths, smoothies, protein shakes, and blended foods through a syringe or straw.
• Soft Foods (4–6 Weeks): As healing progresses, they can eat mashed potatoes, scrambled eggs, and yoghurt.
• Gradual Return to Normal Diet: By 8–12 weeks, patients can slowly reintroduce firmer foods.

3. Speech and Breathing Changes

• Temporary Speech Difficulty: Swelling and limited jaw movement may make speaking difficult, but speech improves over time.
• Nasal Congestion: Since swelling affects airways, patients may experience temporary breathing difficulties. Nasal sprays and humidifiers can help.

4. Recovery Timeline

• First Month: Significant swelling and bruising subside. Patients may return to school or work within 2–4 weeks (depending on their healing progress).
• 3–6 Months: Most jaw function returns to normal, and orthodontic treatment continues to refine bite alignment.
• Full Recovery: Bone healing is complete by 9–12 months, though minor swelling may persist.

5. Follow-Up Care

• Regular Appointments: Patients must see their oral surgeon and orthodontist regularly to monitor healing.
• Jaw Exercises: Surgeons may recommend exercises to restore movement and strength in the jaw.
• Orthodontic Adjustments: If they had braces before surgery, they can wear them to fine-tune their bite.

6. Emotional and Psychological Support

• Temporary Changes in Appearance: Swelling and bruising may alter facial features before the final results appear.
• Emotional Adjustments: Patients may feel self-conscious or frustrated during recovery, so family encouragement and patience are crucial.

Families should stay involved, offer emotional support, and follow medical instructions to ensure a smooth recovery and the best possible outcome.

Orthognathic or Jaw Surgery

Conclusion

Orthognathic surgery is a transformative procedure that enhances jaw function and improves facial balance, speech, and overall quality of life. By correcting misalignment, the surgery addresses functional issues—such as chewing and breathing problems—and aesthetic concerns, boosting confidence and self-esteem. Though recovery requires patience and commitment, the long-term benefits make the journey worthwhile. With the expertise of oral surgeons and orthodontists, patients can achieve a healthier, more harmonious bite and a renewed sense of well-being.